Category: International

This is the third post in a week-long series about different aspects of the Red Cross’ work in Haiti. It was written by Mandy George, our communications delegate in Haiti.

Insurance: something we take for granted. Last week my parents’ house flooded because of a burst pipe in the cold winter weather. Lots of damage, but it will be more or less covered by the insurance.

Not so in Haiti. Yesterday I was talking to our British Red Cross driver, Kermens. He used to own an internet café, but three years ago terrible flooding washed everything away. “The water rose so high that trucks were sitting on roof tops,” he told me. “I lost everything – my business, my car, all the expensive equipment I had saved for years to buy – gone. I was back to square one.”

Imagine this scenario multiplied by hundreds of thousands of livelihoods lost in the devastating earthquake one year ago. People’s jobs and means of survival gone in the blink of an eye. Over a million people in camps, trying to scrape together a living somehow.

For this country to recover in a way that is going to last, people need to be able to get back to work. This is something often overshadowed by the more visible need for rebuilding houses. But if people can go back to work, their ability to rebuild their homes or find somewhere to rent logically follows. And giving people the means to rebuild their own homes as well as their lives is empowering. Aside from that, people have told us that their main priority is to get back to work as soon as possible.

That’s why the British Red Cross is helping people rebuild their own livelihoods, both in Port-au-Prince and in the rural area of Les Cayes.

British Red Cross/Mandy George

We have given an initial 4,000 families from Automeca camp in Port-au-Prince a cash grant of US$250 (around £160) to spend on what they need the most, or consider the most important. This has given them the chance to pay off debts, send their children to school, and in some cases move out of the camp into rented accommodation. We are also going to support 3,000 families in the nearby area of Delmas 19 with cash grants to develop small businesses, and these families will also receive training in basic business skills.

These are skills that people will have for life, not just for the time that the Red Cross will be working in Haiti. And the economic activity this will generate will help the entire neighbourhood that was completely decimated in the earthquake.

Outside of the capital, the structural damage is not visible, but the economic strain is severe. Remittances from Port-au-Prince to rural areas were high before the disaster. As a result, the earthquake also wiped out many rural livelihoods. On top of this, many families moved to rural areas after the quake – extra mouths to feed for the families hosting them, who were struggling to makes ends meet in the first place.

This is why the British Red Cross is also supporting these host families by paying school fees for up to 4,000 children in Les Cayes, as well as supporting up to 3,000 families with cash grants and employment opportunities.

The year since the earthquake has flown by. Every day, I see the strength of the Haitian people fighting a continuous battle for survival in the destruction, amidst cholera and daily insecurities that we would find unbearable. The people we’ve supported over this past year are in a better place than they were. Many of them are inching their way back to a semblance of normality. But it’s going to take a long time for people’s lives to get back on track, and of course they will never be able to replace the loved ones they have lost. Alongside their struggles, we are here to give them a foot up in their own recovery, as much as we can.

It’s easy to take clean water, working toilets, a good sewage system and regular waste disposal for granted. Barring the odd breakdown, these things tend to just work in the UK, without the people who use them thinking very much about them.

So it’s easy to forget that, as well as being convenient, this infrastructure plays a vital role in protecting us from diseases like malaria, dengue fever, diarrhoea, dysentery and cholera.

When the earthquake hit Haiti last January, it devastated water and sanitation systems near the epicentre. It left more than 1.5 million people without access to safe drinking water or a toilet, placing them at risk of diseases. Some found host families further away from the epicentre, but many are still living in sprawling camps where, without adequate sanitation, they would be extremely vulnerable to disease.

Generally after a major disaster, talk centres around what needs to be done to restore pre-disaster levels of water and sanitation service. In Haiti’s case, this won’t be enough. Even before the earthquake, the country’s water and sanitation facilities were chronically under-developed.

In 2008, Haiti’s coverage rate for safe sanitation facilities was the 11th worst in the world, according to the World Health Organisation. Fewer than 70 per cent of people living in cities had regular access to safe water.

The water regulatory agencies had no responsibility for sanitation, meaning there were no sewage systems and individual families made their own arrangements for sanitation according to their economic means. There were also few rubbish collections or street cleaning services in Haiti’s cities, including Port-au-Prince.

Health problems were inevitable with such poor sanitation coverage. Haitian children had on average four to six episodes of diarrhoea a year, several times higher than normal for industrialised countries. Watery diarrhoea caused between five and 16 per cent of child deaths in the country.

There were signs that these problems were being addressed before the earthquake – a new water and sanitation regulatory authority, DINEPA, was created in 2009, but its reform programme had only just begun when the quake hit.

People whose access to clean water and good sanitation was already inadequate suddenly found it was even worse – or in many cases non-existent.

Credit: Claudia Janke

Shortly after the earthquake, the Red Cross started trucking 2.4 million litres of water to displaced person camps in Port-au-Prince every day, enough for around 300,000 people. A year on, this is still happening and is around 40 per cent of all water distributed in the capital.

The Red Cross has also built latrines in camps in Port-au-Prince, Jacmel, Léogâne, Petit-Goâve and Grand-Goâve, used by 265,400 people. The British Red Cross is principally working in two camps in Port-au-Prince – La Piste (50,000 households) and Automeca (4,000 households).

Red Cross volunteers continue to provide extensive hygiene promotion messages to people living in the camps, including messages tailored for children. In the initial stages of the cholera outbreak in November, the Red Cross sent 2 million text messages to Haitians telling them how to take simple hygiene measures to prevent disease.

None of this amounts to a permanent solution to Haiti’s sanitation problems, however. Haiti’s water and sanitation infrastructure needs long-term, sustainable development. DINEPA will work with the Red Cross and other agencies to deliver a three-year water strategy providing this. One of the key goals of this plan needs to be the transferring of municipal services from the Red Cross to the public authorities.

It is likely, however, that the Red Cross will continue to provide safe water to up to 200,000 people in camps, makeshift settlements and the surrounding neighbourhoods in Port-au-Prince for at least the next 18 months.

And as people start to move into transitional shelters, it will be important to make sure they have a sustainable water supply. Water supplies in outlying areas, where there are many host families, will also need to be improved or new water sources created (through the drilling of boreholes, for example).

So there’s a huge amount of challenging work ahead. But there’s also a major opportunity. Over the next few years, aid and development agencies, along with the Haitian authorities, can make sure large numbers of Haitians have access to safe and reliable sanitation for the first time.

Buildings that had once been a much-loved family home reduced to rubble in seconds – these, for me, are still some of the most distressing images from the Haiti earthquake.

I grew up in southern California – an earthquake-prone region. In school we were drilled on what to do if we felt the ground shaking. We were taught to take shelter under our desks and hold on so we’d be protected from falling ceilings. Several times during my childhood, I was woken in the middle of the night by a tremor. I’d run to the doorway and brace myself, never scared that the house would fall down around me. Falling objects and broken windows were my biggest concerns.

People in Haiti could not have had the same confidence in their homes. Before the quake, Haitian homes had been repeatedly ravaged by disasters, particularly hurricanes and floods.

Haiti has also suffered from long-term poverty. It’s the poorest country in the Americas, ranked 145th out of 169 on the UN Human Development Index for 2010. Most of the damage occurred in the poorest parts of Port-au-Prince, where many residents had built their homes with their own hands.

One year on, an estimated 1.4 million people are still living in camps and are highly vulnerable. Some of these people lost their homes in the quake, and others are from Port-au-Prince’s slums who have been drawn to the camps.

Building permanent homes always takes time, and in Haiti’s case there are special circumstances that slow the process down. Rubble is a huge obstacle. Port-au-Prince is a cramped city, and the rubble makes is hugely challenging to get equipment in to remove it.

Plus, before the earthquake, around 80 per cent of Port-au-Prince’s population were tenants or squatters. This makes it extremely difficult to identify the legal owners of plots of land.

Despite these issues, the International Red Cross and Red Crescent Movement has made progress ensuring people have shelter. We participate in the shelter cluster – a group co-ordinating the shelter effort of all the major aid agencies – which distributed emergency shelter to over 2 million people in the first six months.

We began shelter relief (distributing tents, tarpaulins, wood and tools) immediately after the two-week search-and-rescue operation finished, and the pace of distributing that relief was faster than it was for some other recent disasters. Agencies working under the shelter cluster had reached half the people who needed shelter (650,000 people) after six weeks of distribution, averaging just over 110,000 people a week.

The British Red Cross is running a shelter improvement programme in La Piste camp, which has so far helped over 100 families by replacing worn tarpaulins and repairing the wooden frames of damaged shelters.

The International Federation of Red Cross and Red Crescent Societies (IFRC) has built more than 2,500 transitional shelters in Port-au-Prince, Leogane, Jacmel, Marigot, Petit Goave and St Marc. These can last for a few years until families have permanent homes. The IFRC’s committed to providing transitional shelters in areas where people want to live.

British Red Cross/Claudia Janke

There are certainly challenges for the future – including repairing and retrofitting damaged but repairable homes, providing training and materials so people can rebuild their own homes, and establishing income-generating programmes so people can generate money to rebuild their own homes or rent new ones.

We also need to be aware that there’s more to a home than four walls and a roof. A home should be a safe place where a family can be part of a community, and have access to water, sanitation, employment opportunities, and educational facilities.

The sad reality is that people who lost their homes in the earthquake will probably be without a permanent home for a few years. But organisations like the Red Cross are working hard to ensure they have shelter in the meantime.

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As 2010 draws to a close, we’d like to show all our friends, fans, donors, supporters and partners how you’ve helped us make a difference this year.

While 2010 was full of high-profile disasters, our volunteers and staff helped people every day with a wide array of personal crises.

Here’s a look at some of the biggest crises you helped us respond to this year.

January – The Big Freeze

Britain entered the new year covered in a blanket of snow. As the biggest snowfall for decades disrupted travel, schools and communication networks, our volunteers jumped in their vehicles and worked round the clock. Emergency response volunteers supported ambulance services, helped district nurses reach urgent cases, and provided people with blankets and food after power cuts. Care in the home volunteers visited hundreds of vulnerable people to check their welfare. And, when there was a massive increase in winter injuries, our medical equipment services were kept busy loaning out wheelchairs and other mobility equipment.

January – Haiti earthquake

Credit: Talia Frenkel/American Red Cross

The devastating Haiti earthquake on 12 January led to the largest single-country response in Red Cross history. Around 230,000 people died and more than a million were left homeless. We immediately launched an appeal for funds, and the public generously donated, helping us deliver food, hundreds of thousands of tents and tarpaulins, millions of litres of clean water, thousands of cooking sets, and vital medical aid to those who needed it.

Almost one year on, we’re still providing help with sanitation, shelter and livelihoods as Haitian people look to rebuild their lives.

February – first aid for people with disabilities

In February we reported on our three-year project to deliver specially-adapted first aid training for people with disabilities. From September 2006, around 6,000 people took part in one of our inclusive first aid courses. We announced that the programme would continue, getting a big thumbs up from former England and Newcastle United football player Alan Shearer, who said: “It’s easy to assume that because someone is physically disabled or has learning difficulties that they can’t learn first aid, however this just isn’t the case. This fantastic British Red Cross initiative has proved that, with the right training, people with disabilities are more than able to learn the skills to save a life.”

February – Chile earthquake

On 27 February, an earthquake measuring 8.8 on the Richter scale hit Chile. We released £50,000 from our Disaster Fund to help the Chilean Red Cross respond. We also launched an appeal to raise money.

A British Red Cross poll showed that one-in-four British people still believe asylum seekers come to Britain to claim benefits. The survey results were published ahead of Refugee Week, an annual UK-wide programme of arts, cultural and educational events celebrating refugees’ contribution to the UK.

We also launched a report highlighting the dire hardships facing destitute asylum seekers and the urgent need for a more humane asylum system. The report – Not gone, but forgotten – showed that many refused asylum seekers survive on only one meal a day, are unable to work, are homeless, and rely on charities like the Red Cross to survive.

An estimated 20 million people were affected by Pakistan’s worst flooding for 80 years. The floods killed more than 1,700 people and destroyed crops, farms and food, leaving people facing months of hunger.

We sent teams of logistics and sanitation specialists to organise relief items, provide clean toilets and water, and deliver hygiene education to reduce people’s risk of disease.

We held the fifth annual Humanitarian Citizen Award ceremony, which celebrates the extraordinary achievements of young people from across Britain. The overall winner was 15-year-old Cameron Foster from Wigan, who has done countless sponsored runs, walks and abseils to raise thousands of pounds for specialist sports equipment for disabled people.

November – first anniversary of the Cumbria floods

Although many people have moved back into their homes and are rebuilding their lives, the voluntary sector is still providing a wide range of help. Our volunteers have been a consistent and much-needed source of support in Cumbria, making more than 835 visits and 2,200 phone calls to check on people’s welfare.

December – It’s snowing again

We’re closing out the year the way we began it – by helping people struggling with heavy snowfalls, ice, and burst water pipes. We released money from our Disaster Fund to help the snow response in northern Scotland. Our volunteers have been out supporting the emergency services across the UK – from transporting people to and from hospital, to delivering medication to homebound people. And our volunteers in Northern Ireland have been delivering water to people after leaking pipes have left 40,000 people without a water supply.

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Okay I lured you in with the promise of a quiz (it’s at the bottom of the page, I promise!) but please just take a few minutes out of your day to read my blog first.

No matter where you live in the world, no one these days can afford to be ignorant about HIV.

Last week, the Guardian reported that an estimated 86,500 people are living with HIV in the UK, but a quarter of them do not know they are infected.

Earlier this year I travelled to South Africa, the country with the world’s largest number of people living with HIV. In this video, narrated by Annie Lennox, you can hear stories from some of the people I met.

One of the biggest things that really struck me during my visit was that it’s not only the person living with HIV who is affected, but also their families and communities. I met many orphans that the Red Cross is supporting and hearing their stories was truly heartbreaking.

But the good news is that the tide is turning with the global AIDS epidemic, the UN has reported that fewer people are becoming HIV infected and fewer people are dying. This news reflects the success of a massive international effort from governments and organisations to educate communities on the prevention of HIV, particularly around adopting safer sexual practices.

However, with 33.4 million people worldwide still living with the virus the challenge of combating HIV is far from over.

HIV is an emotive subject and many people are frightened to talk about it, let alone think about getting themselves tested.

The fact that there is roughly more than 21,600 people in the UK who do not even know they are infected with HIV worries me. Not only does this mean they are not getting the treatment they need but it also means they continue to put others at risk. It’s time we started talking more openly about this disease and by doing so tackling the fear.

Many young Red Cross volunteers in the UK are well aware that HIV is not just a problem for countries overseas. You can read their stories and find out how they are using creative ideas to raise awareness about the disease, and fight discrimination and stigma.

I’m sure there’s more we can all do to raise awareness about HIV but for starters how about taking the quiz below? Share it with your mates, put it on Facebook and be honest about how many answers you got correct!

Questions:

1. Where was the world’s first case of AIDS identified and in what year?
2. What age group is most affected by HIV?
3. What are the three ways HIV can be transmitted?
4. What is the ABC approach to preventing the spread of AIDS?
5. Is there a cure for HIV?

Answers:

1. The world’s first cases of AIDS were reported in the USA in 1981.*
2. 15-49 is the age group most affected by HIV.
3. HIV can be transmitted through: unprotected sex, blood (particularly through transfusions or intravenous drug use) and from mother to baby (via pregnancy, labour or breast milk).
4. The ABC approach to preventing the spread of AIDS stand for: Abstain, Be faithful, use a Condom. However it’s a controversial approach – read more on AlertNet.
5. There is no cure yet for HIV, but there are drug treatments (antiretroviral therapy) that have transformed the prognosis of people living with HIV, turning it into a chronic condition that can be managed. However, this of course is dependent on the person living with HIV being able to afford/access the treatment and maintain a healthy lifestyle with good nutrition.

Londaka is one of the 1.4 million children who have been orphaned by AIDS in South Africa. Read her story about keeping her memory of her mother alive.

*This previously stated the answer as being Uganda, which was incorrect.

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Mandy George, a Red Cross delegate in Haiti, reports back on the current unrest and developing cholera situation:

Haiti has had to put up with a lot recently. A major earthquake, constant tremors, a hurricane, a cholera epidemic….the list goes on. It is no wonder that there has started to be some unrest in the country.

Yesterday in Cap Haitien, north Haiti, an area that has seen many cholera cases over the past weeks, there were some violent demonstrations. One aid agency working there has begun to pull out. This is very concerning because the needs in Haiti are huge – particularly in the worst affected cholera areas – and reports of violence towards humanitarian aid workers could prevent cholera response operations from reaching those so desperately in need. If no one is left to help this badly affected area, many more may lose their lives.

People are afraid of cholera and desperate for information. They want to know what are the symptoms, can it be cured, what do I do if I think I have cholera?. Cholera is a treatable disease – and is fairly simple to treat – but you have to know to get treatment early, and you have to know that it can be treated. I’ve heard reports of people not seeking help for their families because they think that cholera is always fatal and that there is no point. Lack of information is an underestimated tragedy.

Information empowers people, and we know for a fact that they are actively seeking it. The Red Cross is carrying out a massive awareness campaign with more than two million SMS sent to people living in Artibonite and Port-au-Prince, sharing simple messages about how people could limit their chances of becoming sick. An enormous 75,000 (and this is a conservative estimate) called a free Red Cross information line for more detailed advice on avoiding cholera after receiving these messages, over the course of two days. People want to know how to look after themselves.

The British Red Cross has recognised this need for information since right after the earthquake. A major part of our work in the camps in Port-au-Prince is hygiene promotion- raising awareness among the population as to how to keep healthy, and more recently, how to prevent cholera and how to treat the symptoms. Tragically, cholera has hit the camps in Port-au-Prince, including the enormous La Piste, home to at least 50,000 people. We have set up a cholera treatment centre and rehydration points, and have already dealt with over 300 cases. This two pronged approach of prevention and treatment has kept things under control so far.

People are not asking for a lot. Most do not have access to toilets or running water. The dire sanitation situation in this country is something that we recognise, and have called on the international community to support the government to work to improve this situation. It is shocking how many people bathe openly in the streets, and how many piles of rubbish there are on every street corner.

This is why the Red Cross has also been focussing on improving sanitation in the camps and in some urban areas as much as we can. Of course this is not a sustainable solution and is not something that typically falls under the remit of a humanitarian organisation as it is a municipal function. But for the moment at least we can say that the camps we are working in are clean and people are well informed.. As the cholera crisis escalates, we will be doing our very best to keep things that way.

Photo 1 credit: Severine Vanel/IFRC

Photo 2 credit: Mandy George/BRC

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How do you measure misery? It’s a question that makes me uncomfortable although the fact is my job involves portraying the suffering of survivors of disasters. The more successful I am at this the more I help raise money to alleviate some of their pain. But with Pakistan I feel I have failed.

Last month, I got a chance to ditch my day job as a writer and actually go to Pakistan to help with the distribution of food and other relief goods. I also managed to post a few blogs and photos while I was out there. But since I got back I’ve been slightly dismayed by the general perception of the situation, as time and again people have said to me: ‘How was Pakistan? It doesn’t seem as bad as Haiti.’

Don’t get me wrong, I know the people in Haiti are suffering, especially with this latest cholera outbreak. Earlier this year I met many survivors, including 19-year-old Ambroise whose mother died in the earthquake. He now lives alone in a house made of scraps of wood and metal. I can’t even begin to imagine how I would cope if I were in his situation.

Through our Haiti Earthquake Appeal we raised more than £10 million, money which is much needed and will help with the overwhelming recovery and reconstruction process which will take years.

But with Pakistan we have only raised around £4 million. Now that’s not an amount to be sniffed at and of course we are so grateful to everyone who has donated, but the problem is, it’s not enough. The needs are huge. To put it in perspective the number of people displaced by Haiti’s quake was around 1.3 million, whereas the number of people affected by the Pakistan floods is more than 20 million.

Of course a shocking number of people died in Haiti (200,000) and the images of the capital city reduced to rubble made it easy for us to comprehend the utter devastation and desperate needs of survivors. But in Pakistan, the floods which killed around 2,000 people, are so vast and spread across the country it’s difficult to get a clear picture of the true extent of the disaster.

As winter approaches, the emergency in Pakistan is far from over. Malnutrition rates have risen to 14 per cent and an estimated 30-50 per cent of children arriving at health facilities have shown symptoms of acute malnutrition.

Because of the destruction, people simply have no way to feed themselves – it will be almost a year before many farmers can bring in another harvest. That means people are going to go hungry unless we continue to help them.

Tears roll down a young mother’s face as she rocks her child in her arms outside the Red Cross cholera observation centre in La Piste camp, Port-au-Prince. “My baby, my baby, my baby is sick,” she cries. A Red Cross volunteer asks her when the child fell ill and what his symptoms are. She decides that he is sick enough to be admitted and tells the mother to bring her baby into the observation centre to receive treatment.

The British Red Cross, along with other health care partners, set up the centre as soon as cholera became a threat in Haiti. “We were hoping for the best – not to see cholera in Port-au-Prince – but we were preparing for the worst,” says Borry Jatta, BRC hygiene promotion manager. “This camp is home to at least 50,000 people and is one of the largest in Port-au-Prince. We knew that if cholera came to the city, it would most likely come to La Piste.”

The preparation has paid off: at least 45 people with cholera-like symptoms have been admitted to the centre in the past three days and the centre is well staffed and able to cope with the volume of patients. It is divided into two parts; one is for those needing oral rehydration that they can simply drink, with most people sleeping off the worst of their sickness. The other area is for the more serious cases where patients have already become so dehydrated that they need IV treatment. Red Cross volunteers regularly patrol the centre spraying chlorine to disinfect the floor, beds, buckets and walls.

Widdine, 9, has lived with her family in La Piste since the earthquake. She was brought into the centre by her father in the middle of the night. “It was so fortunate that we could come here,” he explains. “Widdine had been vomiting and loosing fluids through diarrhoea for a couple of hours. I had already heard about cholera from the Red Cross and thought she might have it. So I brought her here and they helped her to rehydrate and looked after her. Slowly she has improved.” Widdine even manages a smile as she gets ready to go home to her shelter on the other side of the camp.

“Making sure people are aware of the symptoms is critical,” explains Borry. “People do not have to die from cholera, but they need to get treatment fast. That is why the British Red Cross has been working since the first cholera case in Haiti to drill these messages into the heads of camp residents, and let them know that they can come to us for help if they need it. Fortunately we have been able to catch quite a few cases early and save their lives.”

Others are not so fortunate. A two year old baby boy lies limp in his mothers arm. Nurses insert an IV drip. His eyes roll back, white and red, without even enough energy to keep his eyes closed. These most severe cases are sent to a nearby cholera treatment centre where they can receive more acute medical help. The parents are helped by Red Cross volunteers to load their two sick children into a waiting ambulance.

“We are afraid,” says Widinne’s father. “We are afraid to sleep in a house since the earthquake. We are afraid because we try to make a living any way we can to take care of our families, but it is hard. We are afraid because of cholera. But we are also lucky because we have somewhere we can get help. I thank God that my little girl is going to be OK.”